A Practicing Dietitian Weighs in on the New Pyramid
Every five years, the Dietary Guidelines for Americans attempt the impossible: one food framework for 330 million bodies. This time around, people have some THOUGHTS (Harvard, American Heart Association, Academy of Nutrition and Dietetics). As a practicing dietitian, here is what I’ve been thinking about this week:
Pyramid vs plate - I think the plate makes more conceptual sense for real life application, but I still didn't love some aspects of MyPlate and would use the ADA Plate Method or Harvard plate more often
Excessive animal protein and insulin resistance
The Dietary Guidelines for Americans are aimed at a “healthy” audience. However, as public health messaging, they go out to the general public - and a lot of our general public is at risk of insulin resistance - 40% of young Americans as of 2021.
We do know that a predominantly animal-protein diet exacerbates insulin resistance (and heart and kidney disease progression).
Demotion of whole grains into the pyramid section that was historically recommended to limit/avoid
Whole grains are a great whole food to regularly include, especially to counter balance the excessive saturated fat that's now being recommended
The pyramid ignores the plethora of complex carbohydrate options available to help provide B-vitamins, soluble fiber, magnesium. I’d like to see quinoa, chia seeds, sunflower seeds, bulgar, farro, corn, and any other number of real foods like this included.
What's missing in the graphic but is in the guidelines
Discouragement of added sugar for kids under 10
I’ll be very curious to see what shakes out from this. We’ve had two generations (Gen X and Milennials) raised with sugar in their childhood, and future generations will likely want to share these fun foods with their kids, too. I wonder how it will translate into public policy and actual impact.
No more specific guidelines on alcohol
Did past years of guidelines recommending less alcohol actually start working? After all, Gen Z has reported not being interested in imbibing compared to past generations.
Ok, wait, so we are pushing fiber?
The written guidelines do promote fiber, fermented foods, and other areas of importance for the gut microbiome. I do wish beans and lentils were featured more prominently on the graphic, which may be more reference-able by the general public.
Things I like
A focus on minimally processed foods - I’ve been saying this for years!
Realfood.gov as a URL is great branding. Memorable, clear, easy to get on board
Inclusion of frozen and canned vegetables and canned fish
While many critics point to lack of consideration of social determinants of health in the development of the guidelines (steak is not cheap!), the acceptance/inclusion of these as whole foods is a win
Fruit is still on here - this helps a LOT. Fruit is not a villain. Fruits of all types and varieties are vital in a balanced diet. And it often gets pushed to the wayside when people think they need to prioritize protein and vegetables.
Final thoughts
When I was studying to become a dietitian, I'd look at a food pyramid from the 90s and thank my lucky stars I wasn't a dietitian back then, having to apologize for what terrible recommendations they were to eat so much of the diet as processed carbs. Now, as a more seasoned dietitian working through this iteration of the food pyramid, I've realized: dietitians in the 90s didn’t have to recommend processed carbs. Many were recommending balanced, whole-foods diets. And I don't have to recommend excessive intake of saturated fats or animal proteins. I can still use robust evidence to support recommendations that I have seen support my clients health time and time again.
Designing a food guide for all Americans is impossible. And every five years, we try again, and inevitably make misaligned recommendations for millions. Because every body is diverse and different. That's America. That's why the food pyramid, MyPlate, whatever version we're working with, is not prescriptive. It's illustrative for the time it's in. But if you want evidence based recommendations tailored to you, work with a dietitian.
